What’s our Greenhouse Effect?

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Noyac said:
I am sure many of you have seen this but for those that have not:

www.npr.org

Effects Of Surgery On A Warming Planet: Can Anesthesia Go Green?

Anesthesia revolutionized surgery by vanquishing patients' pain. But many of the chemicals are greenhouse gases. One Oregon doctor who has done the math says some are much less damaging to the planet.
www.npr.org www.npr.org
Click to expand...

So you gonna stop using des??

Anyone know if he accounted for running low flow des v sevo at 2L?
 
SaltyDog said:
So you gonna stop using des??

Anyone know if he accounted for running low flow des v sevo at 2L?
Click to expand...

I'm assuming he did not account for the difference in flow rates of Desflurane at maybe 0.3 to 0.4 L/min compared to sevoflurance at 2 L/min. Then again he probably didn't calculate the energy usage for the Des vaporizer to heat the Des.

Also if he's arguing for sevo, why not just argue everybody gets a TIVA?
 
Funny. Our group just had a discussion around this. Both environment and costs were brought up in an open forum. I like having DES around, but using Sevo (at low flows) is fine with me as well. If it saves a little and helps with the greenhouse effect then I’m all for that. It doesn’t dramatically change my practice in any way.

Disposable handles (batteries) are not good either btw.
 
262334
 
Sevo is much less soluble than iso, but it'll still never really shine like des with low flows.

As for energy to heat the des vaporizor - that's what, maybe 20 or 30 watts, in a room that's usually lit up like Times Square?

It's coal and oil, not cows and anesthesia.
 
Was Taco Tuesday in the cafeteria taken into account on the calculations?

What about Meatless Monday?
 
One more reason to never use desflurane. With Sevoflurane available, there’s really no reason to use anything else.
 
If you are going to eliminate Des, please negotiate something for the group. It will save the hospital a lot of money depending on current circumstances.

I do believe that Des vaporizer is expensive to purchase. If you have 50 ORs and the Des vaporizers around 10k... we are talking about 1/2 a million in savings directly from anesthesia.
 
And that’s the vaporizer alone.

Just saying... if you go this route bring something back to enhance your current group.
 
Haha... maybe...

Negotiate better contracts by showing value, flexibility, availability and good
outcomes. The last two don’t pertain to this thread.
 
sevoflurane said:
I do believe that Des vaporizer is expensive to purchase. If you have 50 ORs and the Des vaporizers around 10k... we are talking about 1/2 a million in savings directly from anesthesia.
Click to expand...

Only if you stop your hospitals from buying them in the first place, otherwise it’s largely a sunk cost unless 2 situations are present - 1) They are leasing/slowly buying the vaporizers over several years or 2) One can sell the vaporizers for a good amount. But savings from not buying desflurane are very real, especially if your group/hospital are using it frequently.

In training they were pretty stingy with the desflurane and we could only use it if a certain set of circumstances were met... I could never figure it out so I hardly ever used it, and so I rarely use it today.

In Europe, TIVA is the overwhelming majority anesthetic plan and I think they used targeted infusion tech not approved in the US.
 
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In pediatrics we depend on nitrous oxide and Sevoflurane every day for inhalation inductions. Unless it's a very short case, I'm switching to an infusion as soon as an IV is in place.

TIVA made outpatient surgery for me such an enjoyable experience. Volatile...not so much. That the environmental cost of volatile agents is so high only ices the cake.
 
sevoflurane said:
If you are going to eliminate Des, please negotiate something for the group. It will save the hospital a lot of money depending on current circumstances.

I do believe that Des vaporizer is expensive to purchase. If you have 50 ORs and the Des vaporizers around 10k... we are talking about 1/2 a million in savings directly from anesthesia.
Click to expand...

I’d rather just fire 2 administrators.
 
pgg said:
If you fire three, you can afford a classy sending off party, complete with tar and feathers.
Click to expand...
I guess the cost of tar and feathers has gone up since I last checked!
 
AdmiralChz said:
In Europe, TIVA is the overwhelming majority anesthetic plan and I think they used targeted infusion tech not approved in the US.
Click to expand...

It's certainly heading that way here too, TCI's also make doing TIVA much easier / less labour intensive.
Now if only we get propofol in a litre bag ...
 
The answer to this question is Xenon, which is harvested from the atmosphere in the first place and put back after use unchanged.
 
Section31 said:
The answer to this question is Xenon, which is harvested from the atmosphere in the first place and put back after use unchanged.
Click to expand...
Except that even without anesthesia adding to its demand it costs tens of dollars per liter, it has a MAC of 70%, and it has a density 5x that of air. It's a curiosity but that's it.
 
At least now we know why we had such a cold winter here on the West Coast - it’s ‘cuz those clowns in Portland stopped using Des.
 
Put some of the savings into my paycheck and I’ll try to give a damn
 
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